Schedule R (Form 1040) Credit for the Elderly or the Disabled 2004. Summary: This is an example of Schedule R (Form 1040) 2004, Page 1 with items completed per example in the text:
“Name(s) shown on Form 1040” field contains William M. White and Helen A. White
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“Your social security number” field contains 220-00-3333
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Under
“Part I: Check the Box for Your Filing Status and Age”:
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In the section
“Married filing jointly”, line item
“5. Both spouses were under 65, and both retired on permanent and total disability” checkbox checked
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Under
“Part II: Statement of Permanent and Total Disability”:
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“2. Due to your continued disabled condition, you were unable to engage in any substantial gainful activity in 2004, check
this box”
checkbox checked and William written above checkbox.
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